Immunizations: Risks and Requirements

By, Dr. Brett Parkinson, Mountain Medical

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Because of wide-spread vaccination against infectious disease, Americans, as well other citizens around the world, have experienced dramatic improvements in overall health and life expectancy over the last 100 years. Once a deadly disease, smallpox has been eradicated. Polio, though still prevalent in some parts of the world, has been eliminated from the Western Hemisphere. Other potentially serious infections–like measles, mumps, rubella, diphtheria, and Haemophilus influenza type b (Hib)–long feared by parents for their debilitating symptoms and life-threatening potential, have been brought under control by immunization. Vaccination is truly one of medicine’s greatest success stories.

In spite of the success of immunization programs, some parents are hesitant to vaccinate their children, fearful of the minimal risk of side effects and adverse reactions. Medical experts agree, however, that the benefits of vaccination far outweigh the risks for almost all children. And the risks of not vaccinating are very real. Because of high immunization levels in the United States, our children are protected against infections that are still prevalent in other parts of the world. However, if we fail to maintain current immunization levels, we would expose our children to risk of serious infection from bacteria and viruses brought into the US from other parts of the world. If a high percentage of the population, say 85-90%, are immune to a particular disease, then it cannot spread and maintain itself in the population. It will spontaneously die out. This is known as HERD IMMUNITY: A whole population is immune, even though a few of its individuals are not.

HOW DO VACCINATIONS WORK?
A person is injected with a weakened or killed form of a bacterium or virus which has been made into a vaccine. This counterfeit infection “fakes out” the immune system, allowing the body to form antibodies against the disease. When the real infection comes along, the body has made antibodies which attack the disease-causing germs and keeps us from getting sick

REQUIRED VACCINES FOR UTAH SCHOOL CHILDREN:

• Born after 1 July 1986: Diphtheria, Tetanus, Pertussis, Polio, MMR (measles, mumps and rubella)

• Born after 1 July 1993: Diphtheria, Tetanus, Pertussis, Polio, MMR; plus Hepatitis B

• Born after 1 July 1996: Diphtheria, Tetanus, Pertussis, Polio, MMR; plus Hepatitis B, varicella (chickenpox) and Hepatitis A

• Recommended, but not required: Meningococcal vaccine (MCV4) for 11-18 year-olds

Parents or guardians may claim a immunization exemption for medical, religious or personal reasons. This is allowed by Section 53A-11-302 of the Utah Statutory Code. According to the 2007 Utah Immunization Guidebook, the exemption claimed must be accompanied by the appropriate Utah Department of Health Exemption Form. (A medical exemption must be signed by the student’s licensed physician; the religious and personal exemption forms must be witnessed and signed by a local health department representative.)

To download copies of the 2007 Immunization Guidebook, visit http://www.immunize-utah.org (go to School/Child care Information link); or call the Utah Immunization Program at (801) 538-9450. In addition, hard copies can be obtained by written request to: Utah Department of Health Immunization Program/ P.O. Box 142001/ Salt Lake City, Utah/ 84114-2001.

RISKS AND SIDE-EFFECTS OF VACCINES:

• Although 90% of children only notice the needle prick, a few will develop some pain at the injection site, a mild fever or a slight rash.

• Polio vaccine–8 cases of polio/year caused by vaccine in the US; the vaccine is infectious, so it immunizes others in the household; can be dangerous to pregnant women.

MMR vaccine (measles, mumps and rubella): mild symptoms in 10%; causes encephalitis in 1 child out of every 1,000,000; severe allergic reaction in children with egg allergy; dangerous to pregnant women or those with weakened immunity (cancer or AIDS patients). Contrary to some unsubstantiated reports, IT DOES NOT CAUSE AUTISM.
RISKS OF NOT VACCINATING:

MEASLES: Before vaccines, 95% of children had it, so it is common where there is no herd immunity. Causes high fever, cough and rash; lasts about 1 to 2 weeks. Complications include convulsions, hearing loss, inflammation of the brain, mental retardation and even death.

• MUMPS: Before vaccines, most common cause of viral meningitis. Causes high fever, cough, rash and swollen glands under the jaw. 1/4 boys who develop mumps after puberty will develop orchitis (inflammation of the testicles) which may lead to sterility. 1-3.5 deaths/1,000 cases.

RUBELLA: If pregnant woman catches rubella, in more than 50% of cases baby may suffer from congenital rubella syndrome. This can result in deafness, heart disease, mental retardation, cerebral palsy, and an infant mortality rate of 20%.

POLIO: No effective treatment. Causes paralysis, and in 5-10% cases death.

PERTUSSIS (Whooping Cough): Severe coughing and choking, requiring hospitalization in over 50% cases; fatal in 1/170 cases. Convulsions and brain damage can occur.

TETANUS: Can get from minor cut or prick which breaks skin. Causes victim’s muscles to go into spasm; can’t open mouth “lock jaw” or swallow; fatal in 15-30% patients.

DIPHTHERIA: Causes respiratory distress, paralysis and heart failure. 10% die.

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